Organization Active NPI

Premier Medical Associates, PC

  • Foot & Ankle Surgery Podiatrist
  • Monroeville, PA
National Provider Identifier
1679930317
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
PREMIER MEDICAL ASSOCIATES, PC
Practice address
3824 Northern Pike
Ste 960
Monroeville, PA 15146-2141
Phone
(412) 380-2885
Fax
(412) 380-2879
NPI assigned
Jan 26, 2016
Last updated
Jan 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mark Derubeis
Title
Ceo
Phone
(412) 457-0060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PA Primary

Addresses

Primary practice location

3824 Northern Pike
Ste 960
Monroeville, PA 15146-2141

Mailing address

3824 Northern Pike
Ste 700
Monroeville, PA 15146-2141
Phone (412) 457-0060

Other identifiers 1

IdentifierTypeStateIssuer
0009232560009MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1679930317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 NORTHERN PIKE",
            "address_2": "STE 700",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462141",
            "telephone_number": "412-457-0060",
            "fax_number": "412-457-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3824 NORTHERN PIKE",
            "address_2": "STE 960",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462141",
            "telephone_number": "412-380-2885",
            "fax_number": "412-380-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "DERUBEIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "412-457-0060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009232560009",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.